Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | PA-007089-L | PA |
Y | 213ES0000X | Sports Medicine | PA-007089-L | PA |
NPI | 1225018708 |
---|---|
Provider Name | Norman A Gabriel |
First Address | New Castle, PA 16101-3610 |
Second Address | New Castle, PA 16101-3610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014792680001 | (05) | PA |
620883 | HIGHMARK BLUE SHIELD (01) | PA |
S65275 | (02) | PA |